Psychological and educational factors:: Better predictors of work status than FEV1 in adults with cystic fibrosis

Now that more individuals with cystic fibrosis (CF) are living into adulthood, vocational attainment is an increasingly important consideration. Work is a key factor in quality of life. The purpose of the present paper was to evaluate the factors that are associated with work status in 183 adults with CF. Approximately half of the participants were working at the time of evaluation, an impressive figure given that the mean forced expired volume in 1 sec (FEV1) was 31.9%. The average number of hours worked was 32.7 hr/week. The majority of individuals were employed in professional, technical, or managerial occupations (accounting, teaching, law, or social work). A third were employed in clerical and sales occupations, and the remaining individuals were employed in a wide range of other occupations (hotel manager, undercover shopper, artist, or dental technician). Interestingly, FEV, and age did not differentiate between subjects who were working and those who were not. Individuals who were working had significantly lower depression scores and a higher educational level than those who were not working. Future research is needed to determine whether it is the increased socialization and the resulting social support that may come from a work environment, or a reduction in financial stress because of better income and health benefits that helps to explain this difference. Alternatively, work may serve as a distraction from the symptoms of CF. It is likely that those with higher educational levels had more professional jobs that were more easily modified as health declined. Future research needs to assess how career choices are made, and what factors into a patient's decision to keep working. (C) 2004 Wiley-Liss, Inc.